Mind Over Matter

For two decades, psychoanalysts have held fast to their slow, deep exploration of the psyche, reaping only scorn from the science-driven psychiatrists at Washington University. Good thing they didn't listen.

It's an exciting time, with different disciplines taking different paths to the same conclusions, and Moritz is eager to integrate the new scientific findings at the Institute.

She's also eager to share those unprovable insights you can gain only by going deep, appointment after appointment, with one individual at a time. "We are a repository of information that is lost to the current health-care situation," she remarks. "But they are convinced we don't have anything to say."

Eric Nuetzel is succeeding Lynne Moritz as director of the St. Louis Psychoanalytic Institute.
Eric Nuetzel is succeeding Lynne Moritz as director of the St. Louis Psychoanalytic Institute.
Dr. Todd Dean made the jump from Washington University to the St. Louis Psychoanalytic Institute.
Jennifer Silverberg
Dr. Todd Dean made the jump from Washington University to the St. Louis Psychoanalytic Institute.

Moritz grew up in the heyday of psychoanalysis -- but never heard the word. Born in LaGrande, Ore., she spent her free time swimming in the ice-cold Pacific, hiking, skiing, riding bikes and horses, sailing. "Everything was outdoors and action-oriented," she says. "It was the world as it was given to me, and I took it wholeheartedly."

Reminiscing, she first describes the "green, green Douglas firs and, looming over the horizon, Mount Hood, always snow-covered." Then she describes the wrench of losing her father, who went away to war when she was 3 and never came back. "My mother divorced him when I was 5," she explains. "She didn't want him back, but I did. I was Daddy's little girl -- my mom had my younger sister. And that early loss cast a shadow over my life."

Moritz's interest in medicine started soon after, when an adored family friend, the only physician in town, set her broken arm. Determined that she, too, would heal the sick, Moritz regularly embedded her tiny plastic stethoscope in the broom-bristle fur of the family's Scottish terrier. She nursed wounded bunnies, rescued kamikaze birds. "None of them seemed to survive," she admits, "but that only increased my consternation."

She grew up smart and responsible, with a wide, eager Mary Tyler Moore smile and a work ethic she still can't shake. As a freshman at Duke University, she fell in love with a Navy serviceman (in uniform, just like her daddy when he left). They married young and came together to St. Louis University for medical school in the late '60s. She still hadn't read Freud, but she remembers listening, fascinated, while her psychoanalytically trained professors drew meaning from their patients' lives like magicians pulling brilliant silk scarves from a black hat.

Moritz was set on physical healing, though; she wanted to save lives, ease pain, lay hands on swollen, inflamed skin and restore it to health. She had her first baby at the end of medical school and started a residency in pediatrics soon after but couldn't bear tending critically ill newborns while her own baby waited at home. She switched to psychiatry. And when her second baby was stillborn and the grief tore up her marriage, she sought treatment herself.

To her dismay, she was referred to Dr. James Anthony, then chair of child psychiatry at Washington University. (In the 1970s, psychoanalytic credentials were expected of a department chair; today they'd be a liability, and no Wash. U. chairholder would be caught dead practicing analysis.) Moritz had never met Anthony, knew only his formidable reputation. She walked in, gulped and called him sir, and he smiled the gentlest smile she'd ever seen. Then he listened to her, week after week, "in a way no one had ever listened before," she says. Emboldened, she followed his lead, moving "into very dark areas of myself that very much needed healing."

Back in Oregon, the pioneer ethic had ruled: "You pull yourself up by the bootstraps and forge ahead without ever wondering why certain things keep happening," Moritz says. Now, analysis was forcing her to take the time, see the patterns, admit that past hurts were still shaping her reactions to the world. As she did, the old anxiety drained away, and, along with it, the overpowering need "and a tendency toward depression that was tangled up with loss." Convinced that psychoanalysis could heal as surely as any scalpel, Moritz enrolled, in 1974, in the first class at the new St. Louis Psychoanalytic Institute.

Down the street at Wash. U., a revolution in psychiatry was beginning -- the same white-coat revolution that would eventually marginalize psychoanalysis. While Moritz pored over analytic texts, Harvard-trained research psychiatrist Eli Robins logged hours in Wash. U. labs, studying the brain, one cell at a time, and weighing each cell on tiny scales of his own devising. He pioneered studies in the biochemistry of depression, inveigling the coroner for slices of suicides' brains. He resurrected the ideas of a German psychiatrist named Emil Kraepelin, a contemporary of Freud's who refused to speculate about consciousness or "mind" and instead researched the physical brain, making systematic classifications of symptoms and tracing family histories of asylum patients. Kraepelin had nudged the field toward hard science, and Robins wanted to continue that push.

"Eli thought psychoanalysis was silly," remarks his widow, Lee N. Robins, who worked with him at Wash. U., studying family histories of psychiatric disorders, and is now emeritus professor of social sciences in psychiatry. "We were both psychoanalyzed, and we had to go ask our respective analysts if we could get married! The psychoanalytic point of view was that the most important things that happened to people were trauma in early childhood, and since there was just one treatment, diagnosis wasn't of great interest to them. Eli felt just the opposite."

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